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Published June 10, 2020 | Version version 1
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An open letter to Oran and Topol, and the Annals of Internal Medicine

  • 1. 1Division of Infection and Global Health Research, School of Medicine, University of St Andrews, UK
  • 2. 2Division of Infectious Diseases, Toronto General Hospital and University of Toronto, Canada
  • 3. 3 ISARIC Global Support Centre, Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
  • 4. 4INSERM (The Institut national de la santé et de la recherche médicale), Paris, France
  • 5. 5Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Palo Alto, CA, USA
  • 6. 6 Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
  • 7. 7 The Global Outbreak Alert and Response Network (GOARN), Geneva, Switzerland
  • 8. 8 NIHR Southampton Clinical Research Facility and NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK 9 Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, Hampshire, UK
  • 9. 10 Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK


An open letter to Oran and Topol, authors of 

“Presence of Asymptomatic SARS-CoV-2 Infection: A Narrative Review” Annals of Internal Medicine. 2020 June 3.

and Christine Laine (editor-in-chief The Annals of Internal Medicine)

There is a need to better understand the contribution of asymptomatic SARS-CoV-2 infections (those with no symptoms at all throughout the infection) in driving the current pandemic. However, there are caveats that in our opinion are pertinent when interpreting the reported findings of this review, including the lack of a clear definition of asymptomatic infection and selective inclusion of cross-sectional studies. In addition, there is a problematic interpretation of a narrative review containing a dearth of poor-quality evidence resulting in an overestimate of asymptomatic infections, which might misinform policy response.


Open letter to Oran and Topol and the Annals of Internal Medicine.pdf

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